中国组织工程研究 ›› 2013, Vol. 17 ›› Issue (3): 565-570.doi: 10.3969/j.issn.2095-4344.2013.03.029

• 生物材料循证医学 evidence-based medicine of biomaterials • 上一篇    

同种与不同种药物洗脱支架治疗后支架再狭窄的Meta分析

李 盈,李 浪,苏 强,Kyaw Aung Naing   

  1. 广西医科大学第一附属医院心内科,广西壮族自治区南宁市 530021
  • 收稿日期:2012-05-11 修回日期:2012-06-23 出版日期:2013-01-15 发布日期:2013-01-15
  • 通讯作者: 李浪,博士,教授,广西医科大学第一附属医院心内科,广西壮族自治区南宁市 530021 drlilang@163.com
  • 作者简介:李盈★,女,1987年生,四川省成都市人,汉族,广西医科大学在读硕士,主要从事冠心病预防及治疗的研究。 762144630@qq.com

Same versus different types of drug-eluting stents in the treatment of in-stent restenosis: A meta analysis

Li Ying, Li Lang, Su Qiang, Kyaw Aung Naing   

  1. Department of Cardiology, the First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China
  • Received:2012-05-11 Revised:2012-06-23 Online:2013-01-15 Published:2013-01-15
  • Contact: Li Lang, Doctor, Professor, Department of Cardiology, the First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China drlilang@163.com
  • About author:Li Ying★, Studying for master’s degree, Department of Cardiology, the First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China 762144630@qq.com

摘要:

背景:冠心病患者发生药物洗脱支架再狭窄拟行再次支架置入治疗时选择何种类型药物支架尚无定论。
目的:对比同种及不同种药物洗脱支架在治疗冠心病患者首次置入药物洗脱支架后发生再狭窄的有效性和安全性。
方法:计算机检索1984年1月至2012年2月Pubmed数据库、EMBASE数据库、Cochrane图书馆、Google学术搜索及中国生物医学文献光盘等数据库中同种及不同种药物洗脱支架在治疗冠心病患者首次置入药物洗脱支架后发生再狭窄的临床试验,进行 Meta分析。
结果与结论:共纳入6篇,均包括首次置入药物洗脱支架后再次置入西罗莫司洗脱支架或紫杉醇洗脱支架的临床试验,共983例患者。同种与不同种药物洗脱支架处理首次药物洗脱支架置入后再狭窄在全因死亡(P=0.31,I²=14%,OR=0.92,95%CI[0.40,2.08])、再次心肌梗死发生(P=0.64,I²=0,OR=2.68,95%CI[1.00,7.24]、支架内血栓发生率(P=0.82,I²=0,OR=2.02,95%CI[0.37,11.08])及靶病变血管重建(P=0.63,I²=0,OR=1.15,95%CI[0.75,1.76])方面差异无显著性意义。提示同种与不同种药物洗脱支架治疗药物洗脱支架再狭窄的有效性及安全性无差异。

关键词: 生物材料, 生物材料循证医学, 冠心病, 经皮冠状动脉介入治疗, 药物洗脱支架, 雷帕霉素(西罗莫司)洗脱支架, 紫杉醇洗脱支架

Abstract:

BACKGROUND: It is still unknown when drug-eluting stent in-stent restenosis happens, which type of drug-eluting stents should be implanted during percutaneous coronary intervention.
OBJECTIVE: To evaluate the efficacy and safety of the same versus different types of drug-eluting stents in treating coronary artery disease patients suffering from in-stent restenosis after first percutaneous coronary intervention using drug-eluting stents.
METHODS: PubMed, EMBASE, Google Scholar Research, Cochrane Library and Chinese BioMedical Literature Database on disc were searched for clinical trials about the same and different types of
drug-eluting stents in treating coronary artery disease patients suffering from in-stent restenosis after first percutaneous coronary intervention using drug-eluting stents. Then, a meta-analysis was performed.
RESULTS AND CONCLUSION: Six articles were enrolled in the meta-analysis, including 983 cases of in-stent restenosis who received sirolimus-eluting stents or paclitaxel-eluting stents re-implantation following first drug-eluting stent implantation. There were no significant differences between the same and different type of re-implanted drug-eluting stents in all-cause mortality (P=0.31, I2=14%, odd ratio (OR)=0.92, 95% confidence index (CI) [0.40,2.08]), secondary myocardial infarction (P=0.64, I²=0, OR=2.68, 95% CI[1.00,7.24]), the incidence of in-stent thrombosis (P=0.82, I²=0, OR=2.02, 95% CI[0.37,11.08]), and target lesion revascularization (P=0.63, I²=0, OR=1.15, 95% CI[0.75,1.76]). Based on the obtained statistical results, there was no difference between the efficacy and safety of the same and different types of drug-eluting stents for treatment of in-stent restenosis following the first percutaneous coronary intervention using drug-eluting stents.

Key words: biomaterials, evidence-based biomaterials, coronary heart diseases, percutaneous coronary intervention, drug-eluting stents, rapamycin (sirolimus)-eluting stents, paclitaxel-eluting stents

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